Stress Assessment and Management Techniques
The Mind/Body Connection
Emotions have to be expressed, if they aren't, physical symptoms show.
The Brain is the most important part of the nervous system. It controls voluntary processes and involuntary processes. Also a powerful influence on the body (link between emotions and the immune system)
The immune system consists of a trillion cells called lymphocytes. - Waging war against disease of infection. -Receptors on the lymphocytes allow physical and psychological stress to alter the immune system. (Stress causes the body to realse several powerful neurohormones that bind with the receptors on the lymphocytes and suppress immune function).
The immune system consists of a hundred million trillion molecules called antibodies
- One of the most common problems we face and undermines our ability to stay well. Annual cost of stress is $100 billion. It's self-controlled. There is a healthy amount of stress that is needed for optimum health, performance, and well-being.
- The body's mental, emotional, and physiologic reponse to any situation that is new, threatening, frightening, or exciting.
Stressor: -Stress prepares the organism to react to the stress-causing event. -An individual's reaction to a stress-causing agent determines whether that stress is positive or negative.
- Eustress(good stress) - Health and performance continue to improve even as stress increases
- Distress(bad stress) - Refers to the unpleasant or harmful stress under which health and performance begin to deteriorate.
When stress levels reach mental, emotional, and physiologic limits, stress becomes distress and the person no longer functions effectively.
- Body continually strives to maintain homeostasis.
- When homeostasis is interrupted by a stressor triggering a nonspecific response. - General Adaption Syndrome (GAS) - 3 stages
- Alarm Reaction - Immediate response to a stressor (positive or negative)
- Resistance - If the stressor persists (The body calls upon its limited preserves to build up its resistance as it strives to maintain homeostasis).
- Exhaustion/Recovery - If the stress becomes chronic and intolerable (- The body spends its limited reserves and loses its ability to cope. - Entering the exahstion/recovery stage).
- Recovery - In due time, the body recuperates and is able to return to homeostasis.
- If ther chronic stress presists during the exhaustion stage - Immune system is compromised (-Damage body systems. -Head to disease).
Perceptions and Health
- Explanatory style - Habitual manner in which people expain the things that happen to them.
- Pessimistic explanatory style - Interpret events negatively (Delay healing time; worsen the course of illness; compromise immunity).
- Opstimisitc explanatory style - Interprets events in a positive light (-Every cloud has a silver lining. -Increased strength of the immune system; enhance ability to resist infections, allergies, autoimmunities, and even cancer).
- Way of viewing and assessing yourself.
- Healthy self-esteem - Mental and phsyical health.
- Low self-esteem - Worsens chronic pain
A Fighting Spirit
- Involves the healthy expressions of emotions - positive or negative.
- Healthy fighting spirit - Accept disease diagnosis and adopt a fighting attitude (Spontaneous remission).
- Hopelessness - Surrender to despair.
Sources of Stress
- Life Experience Survey - Lab 10A; Life changes in past 12 months)
- Common stressors in the lives of college students - Figure 10.3
Type A - Primarily hard driving, overambitious, aggressive (at times hostile), overly competitive, set their goals; self-motivated, try to accomplish many tasks at the same time; excessively achievement oriented, high degree of time urgency.
Type B - Calm, casual, relaxed, easy-going, take one thing at a time; not pressured or hurried, seldom sets their own deadlines.
Type C - Just as highly stressed as Type A (Do not seem to be at a higher risk for disease than Type B), commited, confidence; control, maintain top physical condition, able to meet mental and physical demands at work.
Changing a Type A Personality
Many are learned behaviors. - Must identify sources of stress, make changes in their behavioral response to the stress, respond more with Type B.
Tips for Managing Anger
- Anger /\ HR and BP - Constriction to blood vessels.
- Over time - Damage arteries, Eventually leads to a heart attack (3fold increased risk for CHD, 7x more likely to suffer a fata; heart attack by age 50).
- Emotional stress is far more effective than physical stress.
- Pages 364-365
Vulnerability to Stress
- Determine your vulnerability (Lab 10C).
- Factors affecting vulnerability to stress - health, social support (The more integrated people are in society, the less vulnerable they are to stress and illness), self-worth, nurturance
- Hassles involved in our daily routine often lead to stress-related illnesses.
- People who don't manage their time properly - Experience chronic stress, fatigue, despair, discouragement, illness
5 Steps to Time Management
- 1. Find the time killers
- 2. Set long-range and short-range goals
- 3. Identify your immediate goals and prioritize then for today and this week.
- 4. Use a daily planner to help you organize and simplify your day.
- 5. Conduct nightly audits
Time Mangement Skills
- Delegate - Get help from someone
- Say no - Activities that keep you from getting top priorities done
- Protect against boredom - Doing nothing cna be a source of stress
- Plan ahead for disruptions - Plan your resonses ahead to deal with saboteurs
- Get it done - One task at a time
- Eliminate distractions - Turn off TV, radio, etc.
- Set aside 'overtimes' - Regularly set aside time you didn't think you would need to finish projects
- Plan time for you - Me time
- Reward yourself - When you finish something, reward yourself and you will contiune to finish things.
Coping with Stress
- The ways people perceive and cope with stress - More important than the development of disease than the amount and type of stress itself.
- Common symptoms of stress - page 368
- Identify the stressor and try to remove the stressor if possible.
- Mechanism that prepares a person to take action by stimulating the vital defense systems -Originates in the hypothalamus and pituitary gland of the brain (Increase - HR,BP, blood flow to active muscles and the brain, glucose levels, O2 consumption, and strength)
- - Necessary for the body to fight or flee (For the body to relaxm one of these actions must take place).
- Benefits in reducing the physiologic and psychological responses to stress.
- One of the simplest tools to control stress
- Reduces the muscular tension and metabolized the increased catecholamines (fight or flight)
- A fatigued muscle is a relaxed muscle.
Benefits are reaped immediately or after engaged in any relaxation technique - Months may be needed to learn some new techniques.
- Interaction with the interior itself - Relationships between the mind and the biological response. - 'feel' how the thought processes influence biological responses (How the biological responses influence the thought process).
- Complex electronic instruments are required - Figure 10.5
Progressive Muscle Relaxation
- Relearn the sensation of deep relaxation
- Progressively contracting and relaxing muscle groups throughout the body - Directions on page 372.
Breathing Techniques for Relaxation
- Improve mental, physcial, and emotional stamina
- The person concentrates on 'breathing away' the tension and inhaling a large amount of air with each breath (Deep breathing, sighing, complete natural breathing).
- Induces a state of relaxtion that rids the body of stress.
- Improves circulation and increases the delivery of healing antibodies and white blood cells tot he site of illness.
- Creation of relaxing visual images and scenes in the times of stress.
Form of self-suggestion - People place themselves in an auto hypnotic state by repeating and concentrating on the feelings of heaviness and warmth in the extremities. Sensation of warmth caused by (Dilation of blood vessels which increases blood flow to the limbs. Muscular relaxation produces the feeling of heaviness - Page 374).
Mental exercise that can bring about psychological and physical benefits - Decreased BP, stress, anger, anxiety, fear, negative feelings, and chronic pain (Pg 374).
- Excellent stress-coping technique.
- Exercise Yoga - Combination of postures, diaphragmatic breathing, muscle relaxation, and meditation (Helps buffer the biological effects of stress). - Helps align musculoskeletal system and increases muscular flexibility, muscular strength, and balance (Treat chemical dependency and insomnia, slows down or reverses atherosclerosis, page 375).
Which Technique is Best?
- Best coping strategy depends on the individual.
- Some are easier to learn and take less time.
Preventing Cardiovascular Disease
In College, Do You Have to Worry About Heart Disease?
Yes, the process starts early in life.
How Much Exercise is Enough to Prevent Heart Disease?
It varies on - genetics,age,gender,body composition,health status, and personal lifestyle.
Trans Fats Are Terrible! What Foods Have Them?
Found primarily in - fried foods (french fries, doughnuts, and apple fritters), baked foods (patries, biscuits, crackers, pie crust, and pizza crust), stick margarine and shortenings.
Why Are Trans Fats Terrible?
/\ the risk for heart disease and stroke by /\ the LDL cholesterol and lowering the HDL cholesterol.
Prevalence of Cardiovascular Disease
- > 35% of all deaths are attributable to CVD
- > 1/3 of the adult population has some form of these diseases of the heart and blood vessels.
- 60% of deaths from heart disease are sudden and unexpected, with no previous signs or symptoms.
Examples of CVD
- Coronary heart disease
- Peripheral Vascular disease
- Congenital heart disease
- Rheumatic heart disease
- High blood pressure
- Congestive heart failure
- Total Cost: $448.5 billion in 2008
Sign of Heart Attack and Stroke
Coronary Heart Disease Risk Profile
- Genetic inheritance plays a role in CHD
- Several major risk factors are preventable and reversible - Most important determinant: lifestyle
- Risk factor analysis: screen, educate, implement programs, use analysis as a starting point and implement intervention programs.
Leading Risk Factors for CHD
- Table 11.2
- A self-assessment of risk factors in Lab 11A - Weighing system shows the impact of each risk factor on developing the disease, the most significant are the heaviest weighted
- Poor cholesterol is one of the best predictors for developing CHD
- Responsible for low levels of cardiorespiratory endurance
- Improving VO2 max helps to control the major risk factors that lead to heart disease - Page 396 for list
- Largest drop in premature death - Between "Unfit" and "Moderately Unfit" groups; a 2-mile walk in 30-40 mins, 5-7 days/wk, is adequate to lower risk
- Vigorous intensity is preferable - greater improvements in aerobic fitness (blood pressure, glucose control, larger reduction in CHD risk)
- Poor lifestyle habits > CVD risk
- Strength training - helps control BW, blood sugar, lowers cholesterol and BP
- Electrocardiogram (FCG or EKG) is a valuable measure of the heart's function - provide a record of the electrical impulses that stimulate the heart to contract
- Doctor's can interpret 5 general areas: HR, heart rhythm, axis of the heart, enlargement or hypertrophy of the heart, myocardial infarction
- Standard 12-lead ECG, 10 electrodes are placed on the person's chest; 12 leads of electrical impluses
- ECG's are taken at rest, during the stress of exercise, and during recovery
- Most practical and inexpensive noninvasive procedure
- "Graded exercise test" or "maximal exercise tolerance test" - The best way to discover CHD on the ECG, Assess cardiorespiratory fitness, Screen for preventive and cardiac rehabilitation, Detect abnormal blood pressure response during exercise, Establish actual or functional maximal HR
- Recommended for: Men > 45 and women >55, total cholesterol >240 mg/dL, LDL>160, HDL<40, hypertensive and diabetic patients, cigarette smokers; family history of CHD, syncope, sudden death before 60; abnormal resting ECG, symptoms of CHD
Abnormal Cholesterol Profile
- #1 prodictor to heart diseaseContributes to atherosclerosis - Triggering myocardial infarction (hidden very well)
- Angina pectoris (pain in chest) - Do not start until the arteries are about 75% blocked
- Recommended total cholesterol: <200 mg/dL - 200-239 borderline high, 240> high risk for disease (the risk /\ 2% for every 1% increase)
Framingham Heart Study
- 60 yr study - Not a single individual with a total cholesterol level of 150 mg/dL < has had a heart attack
- Table 11.3
More Significant, How Cholesterol is Carried
Cholesterol is transported primarily in the form of LDL and HDL (only one that is good) - LDL releases cholesterol (Many penetrate the lining of the arteries and speed atherosclerosis. Cholesterol seems not to cause a problem until it is oxidized by free radicals. - After cholesterol is oxidized, white blood cell invade the arterial wall, take up the cholesterol, and clog the arteries).
Two types: Large or pattern A, Small or patter B - Thought to pass through the inner lining of the coronary arteries more readily, thereby /\ the risk for a heart attack. Predominance of small LDL can lead to a 6-fold increase in the risk for CHD.
Generic variation of LDL cholesterol - Lp(a), High levels promotes (Blood clots, earlier development of atherosclerosis, premature formation of plaque)
IDL - Mid-sized particles are more likely to cause atherosclerosis than a similar amount of LDL cholesterol
Reverse Cholesterol Transport
HDLs act as "scavengers" - Removing cholesterol from the body, preventing plaque from forming in the arteries, strength found in t he HDL is the protein molecules
- HDL2 - Larger particles that carry cholesterol from the arterial wall to the liver for disposal, have antioxidant and anti-inflammatory effects.
- HDL3 - Transport cholesterol out of the arterial wall but may not be as effective, protects against cholesterol osidation that results in atherosclerosis
- Saturated and trans fats raise cholesterol more than anything else - Table 11.4
- Individual differences - Some people can have a higher intake of these tats and maintain normal levels, some people can intake less than recommended and still have higher levels
- Exercise counteractes
- Unsaturated fats are mainly of plant origin - Cannnot be converted to cholesterol
- Vitamin C may inactivate free radicals - Slow the oxidation of LDL cholesterol
- Vitamin E may protect LDL from oxidation - Prevent heart disease
- Should be avoided - Trans fatty acids, hydrogenated fat (/\ shelf life and solidifies to make more spreadable), Partially hydrogenated vegetable oil (/\ LDL cholesterol as much as saturated fats, /\ triglycerides and lower HDL cholesterol, found primarily in processed foods)
- AHA limits trans fat intake - < 1% of total daily caleries
- FDA allows food manufacturers to label any product that has - < 1/2g of trans fat PER SERVING, "partially hydrogenated" and "trans fatty acids" = health risk of saturated fats
- Lower LDL significantly - Fiber intakee must be in the range 25-38g/day, total fat consumption can be in the range of 30%, /\ consumption of vegetables, fruits, whole grains, and beans ( further accelerates the rate of LDL cholesterol reduction)
- Soluble fiber - Help bind and secrete fats from the body, incidence of heart disease is very low (fiber intake exceeds 30g/day)
Harvard University Medical School Study
43,000 middle aged men - followed over 6 years, increased fiber intake to 30g/day, resulted in a 41% reduction in heart attacks
Lower Cholesterol, Lower Fat Intake
- A fat concumption of 10% with regular exercise - lower cholesterol
- Fat consumption < 25% - lower HDL cholesterol , /\ triglycerides
- Allow a diet 35% calories from fat - 10% polyunsaturated, 20% monosaturated, saturated fats at an absolute minimum
- Carbohydrate intake 45-65% calories
- Free fatty acids - High intake of sugars and alcohol /\ levels, make up most of the fat in our diet (most of the fat that circulates in the blood), avoid pastries, candles, soft drinks, fruit juice, white bread, pasta, and alcohol
- Speed up formation of plaque in the arteries
- Carried in the bloodstream - Primarily by VLDLs and chylomicrons
- Hypertension - BP> 140/90
- Prehypertension - BP 120/80 - 139/89
Single largest preventable cause of illness and premature death in the world
What is the Biggest Carcinogenic Exposure in the Environment?
- Tobacco use and exposure to 2nd hand smoke - Responsible for at LEAST 30% of all cancer deaths (87% lung cancer deaths)
- Contributes to 15 additional cancers
Incidence of Cancer
- 2ns leading cause of death in US - 23% of all deaths, leading cause in children 1-14 years
- Major contributor to the increase - Lung cancer, tobacco (30% of all deaths from cancer)
- The other 3rd of death - Unhealthy nutrition, physical inactivity, and excessive body fat
- Figure 12.6
- Cancer will develop in approximately 1 of 2 men and 1 of 3 women - 3 of every 4 families
- 80% of all human cancer is related to - lifestyle, environmental factors (figure 12.7)
- Accounts for 14-20% of deaths from cancer
- 50% /\ risk from dying from any form of cancer
3 types of skin cancer - basal cell carcinoma, squamous cell carcinoma, malignant melanoma (most deadly)
What Can You Do?
- An ounce of prevention is worth a pound of cure
- 60-80% of all cancers are preventable
- 50% are curableMost are lifestyle related, SO BE AWARE